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Blue Mountains
Blue Mountains

Helpful Forms

Personal information, include address and phone number, will be collected after we decide to work together.  When beginning psychotherapy, I provide clients with a packet which includes an overview of my practice along with the billing and cancellation policies reviewed in this website. This packet also includes important facts on client's rights with regard to confidentiality and access to records.   If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.),  please complete the following form to authorize release of psychotherapy information:

  • Authorization to Disclose Information Form

Authorization to Disclose Information Form  

Note: To download Adobe Acrobat Reader for free, click here.

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Helpful Forms

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